Is transluminal coronary angioplasty mandatory after successful thrombolysis? Quantitative coronary angiographic study.

Abstract

Percutaneous transluminal coronary angioplasty has been advocated as a mandatory pro- cedure to prevent reocclusion after successful thrombolysis in acute myocardial infarction. This study describes our experience with both procedures over a 12 month period. Out of 105 patients catheterised in the acute phase of myocardial infarction, 64 were recanalised with 250 000 units of streptokinase, while in 25 patients recanalisation could not be achieved. In the remaining 16, the infarct related vessel was patent at the time of the procedure. Eighteen of the 78 patients who had a patent infarct related vessel at the end of the recanalisation procedure underwent transluminal angioplasty immediately afterwards. Post lysis angiograms were analysed quantitatively with a computerised measurement system. The contours of the relevant arterial segments were detected automatically. Reference diameter, minimal obstruction diameter, length of the lesions, and percen- tage diameter stenosis were averaged from multiple views.